{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:47:11Z","timestamp":1787021231190,"version":"build-2736575974"},"reference-count":32,"publisher":"The Endocrine Society","issue":"2","funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Cabergoline is first-line treatment for most patients with lactotrope pituitary tumors and hyperprolactinemia. Its use at high dosages in Parkinson disease (PD) has largely been abandoned because of its association with the development of a characteristic restrictive cardiac valvulopathy. Whether similar valvular changes occur in patients receiving lower dosages for treatment of hyperprolactinemia is unclear, although stringent regulatory recommendations for echocardiographic screening exist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To conduct a meta-analysis exploring any link between the use of cabergoline for the treatment of hyperprolactinemia and clinically significant cardiac valvulopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>Full-text articles published through January 2017 were found via PubMed and selected according to strict inclusion criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection<\/jats:title>\n                    <jats:p>All case-control studies were included where patients had received \u22656 months of cabergoline treatment for hyperprolactinemia. Single case reports, previous meta-analyses, review articles, and articles pertaining solely to PD were excluded. Of 76 originally selected studies, 13 met inclusion criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Extraction<\/jats:title>\n                    <jats:p>Desired data were compiled and extracted from articles by independent observers. Each also independently graded article quality (bias) and met to reach consensus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis<\/jats:title>\n                    <jats:p>More tricuspid regurgitation was observed (OR 3.74; 95% CI, 1.79 to 7.8; P &amp;lt; 0.001) in the cabergoline-treated patients compared with controls. In no patient was tricuspid valve dysfunction diagnosed as a result of clinical symptoms. There was no significant increase in any other valvulopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Treatment with low-dose cabergoline in hyperprolactinemia appears to be associated with an increased prevalence of tricuspid regurgitation. The clinical significance of this finding is unclear and warrants further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jc.2018-01071","type":"journal-article","created":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T17:43:04Z","timestamp":1536687784000},"page":"523-538","source":"Crossref","is-referenced-by-count":49,"title":["A Meta-Analysis of the Prevalence of Cardiac Valvulopathy in Patients With Hyperprolactinemia Treated With Cabergoline"],"prefix":"10.1210","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9782-8546","authenticated-orcid":false,"given":"Craig E","family":"Stiles","sequence":"first","affiliation":[{"name":"Queen Mary University of London, Department of Endocrinology, London, United Kingdom"},{"name":"Department of Endocrinology, St. Bartholomew\u2019s Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene T","family":"Tetteh-Wayoe","sequence":"additional","affiliation":[{"name":"Queen Mary University of London, Department of Endocrinology, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P","family":"Bestwick","sequence":"additional","affiliation":[{"name":"Queen Mary University of London, Centre for Environmental and Preventive Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard P","family":"Steeds","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom"},{"name":"Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M","family":"Drake","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, St. Bartholomew\u2019s Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2018,9,11]]},"reference":[{"issue":"1","key":"2020071621592659200_B1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1056\/NEJMoa062222","article-title":"Dopamine agonists and the risk of cardiac-valve regurgitation","volume":"356","author":"Schade","year":"2007","journal-title":"N Engl J Med"},{"issue":"1","key":"2020071621592659200_B2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1056\/NEJMoa054830","article-title":"Valvular heart disease and the use of dopamine agonists for Parkinson\u2019s disease","volume":"356","author":"Zanettini","year":"2007","journal-title":"N Engl J Med"},{"key":"2020071621592659200_B3","doi-asserted-by":"crossref","unstructured":"Pinero\n              A\n            , Marcos-AlbercaP, FortesJ. Cabergoline-related severe restrictive mitral regurgitation. N Engl J Med; 2005;353(18):1976\u20131977.","DOI":"10.1056\/NEJM200511033531822"},{"issue":"12","key":"2020071621592659200_B4","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.4065\/77.12.1280","article-title":"Valvular heart disease in patients taking pergolide","volume":"77","author":"Pritchett","year":"2002","journal-title":"Mayo Clin Proc"},{"issue":"2","key":"2020071621592659200_B5","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/S0025-6196(11)62328-8","article-title":"Surgical pathology of carcinoid heart disease: a study of 139 valves from 75 patients spanning 20 years","volume":"77","author":"Simula","year":"2002","journal-title":"Mayo Clin Proc"},{"issue":"9416","key":"2020071621592659200_B6","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/S0140-6736(04)15945-X","article-title":"Treatment of Parkinson\u2019s disease with pergolide and relation to restrictive valvular heart disease","volume":"363","author":"Van Camp","year":"2004","journal-title":"Lancet"},{"key":"2020071621592659200_B7","unstructured":"US Food and Drug Administration; Consumer Updates. Withdrawal of Parkinson\u2019s Treatment - Pergolide. Available at: https:\/\/web.archive.org\/web\/20120302085215\/http:\/\/www.fda.gov\/ForConsumers\/ConsumerUpdates\/ucm048819.htm. Published 17 April 2007. Accessed 9 January 2018."},{"key":"2020071621592659200_B8","unstructured":"Medicines and Healthcare Products Regulatory Agency\n          . 2008. Ergot-derived dopamine agonists: risk of fibrotic reactions. Available at: www.gov.uk\/drug-safety-update\/ergot-derived-dopamine-agonists-risk-of-fibrotic-reactions. Published 11 December 2014. Accessed 9 January 2018."},{"key":"2020071621592659200_B9","unstructured":"Pfizer Limited, United Kingdom; Medicines and Healthcare products Regulatory Agency; 2008. Cabaser Final Letter. Available at: http:\/\/webarchive.nationalarchives.gov.uk\/20141205150130\/http:\/\/www.mhra.gov.uk\/home\/idcplg?IdcService=GET_FILE&dDocName=CON028263&RevisionSelectionMethod=Latest. Accessed 9 January 2018."},{"issue":"12","key":"2020071621592659200_B10","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1007\/BF03345662","article-title":"Cabergoline therapy and the risk of cardiac valve regurgitation in patients with hyperprolactinemia: a meta-analysis from clinical studies","volume":"31","author":"Bogazzi","year":"2008","journal-title":"J Endocrinol Invest"},{"issue":"8","key":"2020071621592659200_B11","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1007\/s00059-013-3816-0","article-title":"Cabergoline use and risk of fibrosis and insufficiency of cardiac valves. Meta-analysis of observational studies","volume":"38","author":"De Vecchis","year":"2013","journal-title":"Herz"},{"issue":"10","key":"2020071621592659200_B12","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jclinepi.2009.06.006","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration","volume":"62","author":"Liberati","year":"2009","journal-title":"J Clin Epidemiol"},{"issue":"5","key":"2020071621592659200_B13","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1111\/j.1365-2265.2010.03973.x","article-title":"Cardiac valve disease and low-dose dopamine agonist therapy: an artefact of reporting bias","volume":"74","author":"Gu","year":"2011","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"11","key":"2020071621592659200_B14","doi-asserted-by":"crossref","first-page":"4189","DOI":"10.1210\/jc.2016-2224","article-title":"A follow-up study of the prevalence of valvular heart abnormalities in hyperprolactinemic patients treated with cabergoline","volume":"101","author":"Drake","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071621592659200_B15","unstructured":"Wells\n              GA\n            , SheaB, O\u2019ConnellD, PetersonJ, WelchV, LososM, TugwellP. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2018. Available at: www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp."},{"issue":"12","key":"2020071621592659200_B16","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1111\/j.1742-1241.2008.01779.x","article-title":"Treatment with low doses of cabergoline is not associated with increased prevalence of cardiac valve regurgitation in patients with hyperprolactinaemia","volume":"62","author":"Bogazzi","year":"2008","journal-title":"Int J Clin Pract"},{"issue":"1","key":"2020071621592659200_B17","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1007\/s11102-011-0339-7","article-title":"A comparison of cabergoline and bromocriptine on the risk of valvular heart disease in patients with prolactinomas","volume":"15","author":"Boguszewski","year":"2012","journal-title":"Pituitary"},{"issue":"10","key":"2020071621592659200_B18","doi-asserted-by":"crossref","first-page":"3777","DOI":"10.1210\/jc.2007-1403","article-title":"Increased prevalence of tricuspid regurgitation in patients with prolactinomas chronically treated with cabergoline","volume":"93","author":"Colao","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2020071621592659200_B19","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.recesp.2012.10.020","article-title":"Valvular heart disease in hyperprolactinemic patients treated with low doses of cabergoline","volume":"66","author":"C\u00f3rdoba-Soriano","year":"2013","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"issue":"1","key":"2020071621592659200_B20","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1530\/EJE-12-0121","article-title":"Increased prevalence of subclinical cardiac valve fibrosis in patients with prolactinomas on long-term bromocriptine and cabergoline treatment","volume":"167","author":"Elenkova","year":"2012","journal-title":"Eur J Endocrinol"},{"issue":"2","key":"2020071621592659200_B21","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1365-2265.2012.04349.x","article-title":"No clinically significant valvular regurgitation in long-term cabergoline treatment for prolactinoma","volume":"77","author":"Halperin","year":"2012","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"1","key":"2020071621592659200_B22","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/j.1365-2265.2008.03458.x","article-title":"Valvular heart disease and the use of cabergoline for the treatment of prolactinoma","volume":"70","author":"Herring","year":"2009","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"9","key":"2020071621592659200_B23","doi-asserted-by":"crossref","first-page":"3348","DOI":"10.1210\/jc.2007-2658","article-title":"Aortic valve calcification and mild tricuspid regurgitation but no clinical heart disease after 8 years of dopamine agonist therapy for prolactinoma","volume":"93","author":"Kars","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2020071621592659200_B24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1530\/EJE-08-0213","article-title":"Cabergoline and the risk of valvular lesions in endocrine disease","volume":"159","author":"Lancellotti","year":"2008","journal-title":"Eur J Endocrinol"},{"issue":"1","key":"2020071621592659200_B25","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1111\/j.1365-2265.2009.03608.x","article-title":"Gender effects on cardiac valvular function in hyperprolactinaemic patients receiving cabergoline: a retrospective study","volume":"72","author":"Nachtigall","year":"2010","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"3","key":"2020071621592659200_B26","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/j.1365-2265.2010.03827.x","article-title":"Assessment of cardiac valve dysfunction in patients receiving cabergoline treatment for hyperprolactinaemia","volume":"73","author":"Tan","year":"2010","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"3","key":"2020071621592659200_B27","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s11102-008-0134-2","article-title":"Long-term cabergoline therapy is not associated with valvular heart disease in patients with prolactinomas","volume":"12","author":"Vallette","year":"2009","journal-title":"Pituitary"},{"issue":"4","key":"2020071621592659200_B28","doi-asserted-by":"crossref","first-page":"R11","DOI":"10.1530\/EJE-08-0365","article-title":"Low dose cabergoline for hyperprolactinaemia is not associated with clinically significant valvular heart disease","volume":"159","author":"Wakil","year":"2008","journal-title":"Eur J Endocrinol"},{"issue":"3","key":"2020071621592659200_B29","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1530\/EJE-13-0231","article-title":"Safety of long-term treatment with cabergoline on cardiac valve disease in patients with prolactinomas","volume":"169","author":"Auriemma","year":"2013","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2020071621592659200_B30","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1111\/j.1445-5994.2009.01920.x","article-title":"Low-dose cabergoline causing valvular heart disease in a patient treated for prolactinoma","volume":"39","author":"Cawood","year":"2009","journal-title":"Intern Med J"},{"issue":"3","key":"2020071621592659200_B31","first-page":"133","article-title":"A case of iatrogenic severe mitral regurgitation","volume":"80","author":"D\u2019Aloia","year":"2013","journal-title":"Monaldi Arch Chest Dis"},{"issue":"6","key":"2020071621592659200_B32","first-page":"797","article-title":"Severe tricuspid regurgitation in a patient receiving low-dose cabergoline for the treatment of acromegaly","volume":"19","author":"Izgi","year":"2010","journal-title":"J Heart Valve Dis"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/104\/2\/523\/27378265\/jc.2018-01071.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/104\/2\/523\/27378265\/jc.2018-01071.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T05:45:39Z","timestamp":1594964739000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/104\/2\/523\/5094016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,11]]},"references-count":32,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2018-01071","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,2]]},"published":{"date-parts":[[2018,9,11]]}}}